Determination of Sera NGAL Levels in Patients with Lung Cancer and Its Relation with Apoptosis

The synthesis of neutrophil gelatinase associated lipocalin (NGAL) is known to be induced in neoplasms, potentially aiding in the assessment of carcinogenesis and tumor progression. This study investigates NGAL expression in lung cancer patients and its association with apoptosis. Conducted at the Thoracic Surgery Clinic of Selçuk University, the study involved patients aged 40-70 diagnosed with lung cancer. Exclusion criteria included acute stroke, rheumatic diseases, chronic kidney disease, congestive heart failure, chronic infections, and cancers other than lung cancer. Two groups were assessed: a lung cancer group (N=40) and a control group (N=40). Using ELISA, NGAL and M30 levels in serum were determined, with lung cancer patients showing significantly higher levels (NGAL: 424.03±74.49 ng/mL; M30: 144.08±45.91 U/L) compared to controls (NGAL: 374.04±90.34 ng/mL; M30: 118.76±46.16 U/L), with p<0.01. A positive correlation between NGAL and M30 was observed (Spearman’s r=0.58, p<0.01). Immunohistochemical analysis revealed lower apoptotic indexes in cancerous tissues than in adjacent normal tissues (p<0.01), suggesting alternative cell death pathways may predominate in lung cancer. These findings support the hypothesis that apoptosis may be inhibited in cancerous tissues, and the increased NGAL and M30 levels align with previous studies indicating NGAL-induced apoptosis and cellular iron reserve depletion in cancer.